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General NPI Number Information
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NPI Number | 1922452234
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Entity Type | Individual
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Provider Name | MOLLY RAE TERRY LMHC-D
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Gender | Female
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 300 INTERNATIONAL DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5781
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Country | US
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Telephone | 716-275-0975
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Fax |
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Provider Business Mailing Address
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Address Line | 300 INTERNATIONAL DR STE 128
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5781
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Country | US
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Telephone | 716-275-0975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 007171-1
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License Number State | NY
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